One of Quebec’s busiest trauma centres, the Montreal General Hospital, is cancelling complex surgeries because of a “tremendous bed shortage.”

Emergencies, trauma and unpredictable life-threatening accidents get priority, but surgeries —from knee and hip replacements to colon and lung tumour removal that require hospitalization — are subject to cancellation.

An internal letter to staff, obtained by the Montreal Gazette, explains that the opening of the superhospital required the MUHC to shift nurses toward the Glen site and that has affected the General’s operating room capacity and surgical in-patient beds.

The hospital has reduced its surgical capacity by 11 per cent — from 108 beds to 96 beds — as a result.

MUHC officials confirm bed closures on several floors at the General, but say meetings are held every morning to assess patients for surgery based on medical priority and best standards of care.

On Friday, seven operations were cancelled. Monday’s surgeries went ahead as planned. On average, one to two surgeries are cancelled daily, said a source who works in the operating rooms and asked not to be named because they are not authorized to speak to the media

The General tried to mitigate the effects of reorganizing local services prior to the Glen’s opening on Sunday, said Gerald Fried, MUHC surgeon-in-chief, adding that it’s not the first time the hospital has cancelled surgeries, including when beds were closed during flu epidemics in winter.

“We catch up. People are sensitive to wait times and we are doing our best to prioritize (surgical) activities.”

Surgeons at the General, however, said they are worried about their patients.

“We’re cancelling surgeries due to lack of beds almost daily,” the source said. “We try to prioritize cancer cases, but it’s not always possible. These are also regularly cancelled and pushed two weeks ahead. If we cancel your mom with colon cancer that means your mom will live with colon cancer growing in her belly.”

The letter, which was sent last month, explained “the current reality is that we are continuing to run our OR at full capacity, but with only 96 beds opened because of staff shortage and sick calls. Unfortunately, another five beds may have to be closed …”

It urged doctors to book day surgeries rather than admitting patients to the hospital to avoid cancellation and warned the situation is not likely to improve for several weeks after the Glen opens. It noted that patients with complex cases, for example, with cancer, or those requiring extensive pre-operation preparations, would not be not spared surgery delays: “We … have been unable to completely protect these patient populations.”

Physicians have voiced their concerns, but said the pressure to conform comes from above. The new superhospital will also have fewer beds than at the current MUHC, they said.

The redeveloped $1.3-billion MUHC will have a total of 832 short-term beds between the Glen campus and the General, which is 107 fewer beds than currently available at the General, the Royal Victoria and Montreal Chest hospitals, combined — the latter two are slated to close when the Glen site opens on Sunday.

During March break at the beginning of the month, the hospital temporarily closed six of its 10 operating rooms and now more bed cuts are affecting care, the source said.

Asked why the hospital didn’t factor workforce restriction into its transition to the Glen since the move has been prepared for two years, Fried replied that there have been many changes in the health system that were not on the books two years ago, including a different budget and a different government.

“There isn’t an abundance of nurses looking for work that we have to draw from,” he said. “And it takes time and people to train them.”

The General didn’t have the budget to recruit and expand its nursing staff, he said, which factored in the planning.

“Believe me, my goal as a surgeon is to take care of patients. We will get through this,” Fried said. “But it’s a little bit of perfect storm.

“We’re moving to a new environment, our partners in the health system are going through a completely new adjustment and our government is going through a period of austerity planning, which has restricted budgets for everybody,” he said.

Closing beds for lack of funding is unacceptable, said Pierre Blain, director of the provincial patients’ group, Regroupement provincial des comités des usagers. “It’s extremely worrisome,” he said, for patients and their families who are already stressed because of a diagnosis of cancer. “It’s a terrible blow.”

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